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Testicular Tumours

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Testicular Tumours

10
Q. 1 Which among the following are Testicular tumour markers?
 
1. β-hCG
2. AFP
3. LDH
4. CA-125
5. CEA
 A 1,2,3 True & 4,5 False
 B 1,2,3 False & 4,5 True
 C

1,2,5 False & 3,4 True
 D

1,2,5 True & 3,4 False
Q. 2

Which one of the following is not used as a tumor marker in testicular tumours ?

 A

AFP
 B

LDH
 C

HCG
 D

CEA
Q. 3

Regarding testicular tumour, the following are false except –

 A

They are commonest malignancy in older man
 B

Seminomas are radiosensitive
 C

Only 25% of Stage 1 teratomas are cured by surgery alone.
 D

Chemotherapy rarely produces a cure in those with metastatic disease
Q. 4

Most malignant testicular tumour –

 A

Embryonal cell carcinoma
 B

Seminoma
 C

Choriocarcinoma
 D

b and c
Q. 5

Testicular tumour can simulate ‑

 A

Hydrocele
 B

Scrotum
 C

Acute epidydimo orchitis
 D

Chronic orchitis
Q. 6

Testicular tumour most sensitive to radiation is‑

 A

Teratoma
 B

Lymphoma
 C

Mixed germ cell tumor
 D

Seminoma
Q. 7

All of the following testicular tumours are germ cell tumours EXCEPT:   

March 2013 (b)

 A

Seminoma
 B

Teratoma
 C

Choriocarcinoma
 D

Sertoli cell tumour
Q. 8

Most common testicular tumour in 4th decade is:

March 2009

 A

Teratoma
 B

Dermoid
 C

Seminoma
 D

All of the above
Q. 9

Testicular tumour which responds best to radiation is:

 A

Teratoma
 B

Seminoma
 C

Embryonal cell carcinoma
 D

None of the above
Q. 10

True regarding testicular tumour:

 A

For stage I seminoma- orchidectomy alone used for treatment
 B

For stage I seminoma- orchidectomy + radiotherapy used for treatment
 C

Stage I non-seminomatous germ cell tumour-orchidectmy +radiotherapy used for treatment
 D

Staging is important for planning management
Q. 1

Which among the following are Testicular tumour markers?

 
1. β-hCG
2. AFP
3. LDH
4. CA-125
5. CEA
 A 1,2,3 True & 4,5 False
 B

1,2,3 False & 4,5 True
 C

1,2,5 False & 3,4 True
 D

1,2,5 True & 3,4 False
Ans. A
Explanation:

Three serum tumor markers have established roles in the management of men with testicular germ cell tumors:

1. The beta subunit of human chorionic gonadotropin (β-hCG)
2. Alpha fetoprotein (AFP)
3. Lactate dehydrogenase (LDH)
Q. 2 Which one of the following is not used as a tumor marker in testicular tumours ?
 A

AFP
 B

LDH
 C

HCG
 D

CEA
Ans.
D
Explanation:

Ans. is ‘d’ i.e., CEA

Biological markers of germ cell testicular tumors include AFP, HC Placental alkaline phosphatase, placental lactogen and LDH. HCG , AFP and LDH are widely used clinically and have proved to be valuable in the diagnosis and management of testicular cancer.

Q. 3

Regarding testicular tumour, the following are false except –

 A They are commonest malignancy in older man
 B

Seminomas are radiosensitive
 C

Only 25% of Stage 1 teratomas are cured by surgery alone.
 D

Chemotherapy rarely produces a cure in those with metastatic disease
Ans.
B
Explanation:

Ans is ‘b’ i.e. Seminomas are radio sensitive 

Seminomas are well known to be one of the most radiosensitive tumors

About other options

  • Option (a) : Commonest malignancy in older males is —> Prostate cancer
  • Option (c) : Stage I Nonseminomas (including teratomas) are t/t by surgery alone and show a high cure rate (>95%)

[Stage I seminomas are t/t by surgery + retroperitoneal radiotherapy and show —98% cure rate]

  • Option (d) : Chemotherapy shows a good response in advance stage testicular tumors.
Q. 4 Most malignant testicular tumour –
 A Embryonal cell carcinoma
 B

Seminoma
 C

Choriocarcinoma
 D

b and c
Ans.
D
Explanation:

Ans. Two options are correct i.e., `b & c’ 

Q. 5

Testicular tumour can simulate ‑

 A

Hydrocele
 B

Scrotum
 C

Acute epidydimo orchitis
 D

Chronic orchitis
Ans.
B
Explanation:

Ans. is ‘b’ i.e., Scrotum 

Q. 6

Testicular tumour most sensitive to radiation is‑

 A

Teratoma
 B

Lymphoma
 C

Mixed germ cell tumor
 D

Seminoma
Ans.
D
Explanation:

Ans. is ‘d’ i.e., Seminoma

Testicular seminoma is the germ cell tumor, which is very sensitive to radiation therapy.

Q. 7

All of the following testicular tumours are germ cell tumours EXCEPT:   

March 2013 (b)

 A

Seminoma
 B

Teratoma
 C

Choriocarcinoma
 D

Sertoli cell tumour
Ans.
D
Explanation:

Ans. D i.e. Sertoli cell tumour

Testicular carcinoma

  • Bilateral in 10% of cases,
  • Abdominal cryptorchid testes are at higher risk as compared to inguinal cryptorchid testes
  • Testicular feminization syndrome increases the risk of testicular germ cell tumour
  • MC Ca of testes in young: Seminoma
  • MC Ca in elderly: Lymphoma
  • MC Ca in infants: Yolk sac tumour

Seminoma

  • Radiosensitive,
  • Corresponds to dysgerminoma of ovary &
  • Treatment of choice is: Surgery

Germ Cell Tumors

  • Precursor lesion
    • Intratubular germ cell neoplasm, unclassified
    • Intratubular germ cell neoplasm, specific type
  • Tumors of 1 histologic type
    • Seminoma
      • Variant: Seminoma with syncytiotrophoblastic cells
      • Partially regressed tumor showing seminoma with scar
    • Spermatocytic seminomaEmbryonal carcinoma
      • Variant: Spermatocytic seminoma with a sarcomatous component
    • Yolk sac tumor
    • ChoriocarcinomaPlacental site trophoblastic tumor
      • Variant: “Monophasic” type
    • Trophoblastic tumor, unclassified
    • Teratoma
      • With a secondary somatic type malignant component
      • Monodermal variants
        • Carcinoid
        • Primitive neuroectodermal tumor
        • Others
Q. 8 Most common testicular tumour in 4th decade is:

March 2009

 A Teratoma
 B

Dermoid
 C

Seminoma
 D

All of the above
Ans.
C
Explanation:

Ans. C: Seminoma

Peak incidence for teratomas is 20-35 years and for seminomas is 35-45 years Seminoma is rare before puberty.

Q. 9

Testicular tumour which responds best to radiation is:

 A

Teratoma
 B

Seminoma
 C

Embryonal cell carcinoma
 D

None of the above
Ans.
B
Explanation:

Ans. Seminoma

Q. 10

True regarding testicular tumour:

 A

For stage I seminoma- orchidectomy alone used for treatment
 B

For stage I seminoma- orchidectomy + radiotherapy used for treatment
 C

Stage I non-seminomatous germ cell tumour-orchidectmy +radiotherapy used for treatment
 D

Staging is important for planning management
Ans.
B:D:E
Explanation:

Answer- B,For stage I seminoma- orchidectomy + radiotherapy used for treatment D,Staging is important for planning management E,i3HCG & AFP may be used as marker the response of treatment

Testicular Tumour: Staging

  • Stage I: The tumour is confined to the testis;
  • Stage II: Nodal disease is present but is confined nodes below the diaphragm;
  • Stage III: Nodal disease is present above the diaphragm;
  • Stage IV: Nonlymphatic metastatic dise
  • In confirmed cases, staging is an essential step in planning treatment.
  • HCG & NSGCTs when raised, these markers are used to monitor the response to treatment.